[1]高 峰,黄祥忠,任冬青,等.导管鞘辅助穿刺技术在CT引导微波消融治疗原发性肝癌中的应用[J].介入放射学杂志,2016,(12):1074-1077.
 GAO Feng,HUANG Xiang- zhong,REN Dong- qing,et al.Application of catheter sheath- assisted puncture technique in CT- guided percutaneous microwave ablation therapy for primary hepatocellular carcinoma[J].journal interventional radiology,2016,(12):1074-1077.
点击复制

导管鞘辅助穿刺技术在CT引导微波消融治疗原发性肝癌中的应用 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2016年12期
页码:
1074-1077
栏目:
非血管介入
出版日期:
2016-12-25

文章信息/Info

Title:
Application of catheter sheath- assisted puncture technique in CT- guided percutaneous microwave ablation therapy for primary hepatocellular carcinoma
作者:
高 峰 黄祥忠 任冬青 沈 炜 郭新春 高福磊 包凯沪
Author(s):
GAO Feng HUANG Xiang- zhong REN Dong- qing SHEN Wei GUO Xin- chun GAO Fu- lei BAO Kai- hu
Department of Interventional Radiology, Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin, Jiangsu Province 214400, China
关键词:
【关键词】 肝癌 微波 CT引导 导管鞘辅助
文献标志码:
A
摘要:
【摘要】 目的 回顾性病例对照研究CT引导导管鞘辅助穿刺技术在微波治疗原发性肝癌的优势及临床应用价值。方法 收集2013年10月至2015年9月接受微波治疗的临床或病理诊断的原发性肝癌患者41例,所有患者均先行TACE治疗,TACE治疗后1个月行经皮微波消融(MWA)治疗,共消融56枚病灶,最大径<3 cm 43枚, 3~5 cm 8枚, >5 cm 5枚。导管鞘辅助穿刺技术在传统穿刺基础上,先引入导管鞘,再经鞘管同轴送入微波针进行消融。采用传统微波针直接穿刺16例20枚病灶;导管鞘辅助穿刺25例36枚病灶。MWA治疗后1个月查增强MR评估疗效。结果 41例患者成功完成TACE联合经皮MWA治疗。两种穿刺术1次穿刺成功率比较差异具有统计学意义(P=0.004);病灶最大径<3 cm两组1次穿刺成功率比较差异具有统计学意义(P=0.008),而病灶最大径3~5 cm及>5 cm两组1次穿刺成功率则无明显差异(P>0.05);同一种穿刺方法不同大小病灶1次穿刺成功率均无明显差异(P>0.05)。两种穿刺均有一定的并发症发生,其中出血、血管瘘发生率两者比较差异具有统计学意义(P=0.008,P<0.001),而针道转移发生率则无明显差异(P>0.05)。治疗后1个月两组疗效比较差异无统计学意义(P>0.05)。结论 CT引导导管鞘辅助穿刺技术的应用可有效减少原发性肝癌微波治疗中的穿刺次数,从而降低了出血、血管瘘等穿刺并发症的发生率,提高了手术的安全性,临床值得进一步推广应用。

参考文献/References:

[1] Ding J, Jing X, Liu J, et al. Comparison of two different thermal techniques for the treatment of hepatocellular carcinoma[J]. Eur J Radiol, 2013, 82: 1379- 1384.
[2] Bruix J, Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma[J]. Hepatology, 2005, 42: 1208- 1236.
[3] Ni JY, Sun HL, Chen YT, et al. Prognostic factors for survival after transarterial chemoembolization combined with microwave ablation for hepatocellular carcinoma[J]. World J Gastroenterol, 2014, 20: 17483- 17490.
[4] 经 翔, 丁建民, 王彦冬, 等. 射频消融和微波消融治疗肝癌的比较[J]. 介入放射学杂志, 2014, 23: 306- 310.
[5] 邹勇斌, 范卫君, 张 亮, 等. 肝动脉化疗栓塞联合微波消融治疗巨块型肝癌的疗效分析[J]. 实用医学杂志, 2012, 28: 2759- 2761.
[6] 常 鹏, 张洪义, 肖 梅. 单纯经肝动脉化疗栓塞术及其联合微波消融治疗原发性大肝癌的疗效对比分析[J]. 临床肝胆病杂志, 2015, 31: 880- 885.
[7] 王 阁, 李 建. 重视影像学检查在肝占位性病变鉴别诊断中的地位[J]. 实用肝脏病杂志, 2013, 16: 385- 388.
[8] Miyayama S, Matsui O, Zen Y, et al. Portal blood supply to locally progressed hepatocellular carcinoma after transcatheter arterial chemoembolization: Observation on CT during arterial portography[J]. Hepatol Res, 2011, 41: 853- 866.
[9] 余国政, 廖子君, 邱发凯, 等. 冷循环微波消融联合TACE治疗原发性肝癌的临床研究[J]. 现代肿瘤医学, 2013, 21: 1306- 1309.

相似文献/References:

[1]杨永波,程红岩.肝动脉化疗栓塞治疗中碘油用量的现状与研究进展[J].介入放射学杂志,2012,(04):348.
 .The volume of Lipiodol used in TACE: its current situation and research progress [J].journal interventional radiology,2012,(12):348.
[2]沈 强,王 能,盛月红,等.高功率微波消融治疗近大血管肝细胞癌33例[J].介入放射学杂志,2012,(05):391.
 ,,et al. Microwave ablation using high power output for the treatment of hepatocellular carcinoma located near the large vessels: initial results in 33 cases[J].journal interventional radiology,2012,(12):391.
[3]帕哈尔丁·白克热,杨树法,黄伍奎,等.肝动脉化疗栓塞联合射频消融术治疗30例原发性大肝癌的疗效评价[J].介入放射学杂志,2012,(04):322.
 ,,et al.TACE combined with radiofrequency ablation for massive primary hepatocellular carcinomas: a clinical therapeutic evaluation [J].journal interventional radiology,2012,(12):322.
[4]张   磊,陆骊工,李   勇,等.门静脉支架联合肝动脉化疗栓塞治疗肝癌伴门静脉癌栓的临床研究[J].介入放射学杂志,2011,(12):968.
 ZHANG Lei,LU Li-gong,LI Yong,et al.Portal vein stent placement combined with TACE for the treatment of hepatocellular carcinoma associated with tumor thrombus in portal vein[J].journal interventional radiology,2011,(12):968.
[5]敖 劲,张跃伟,徐 克. 明胶海绵微粒经动脉栓塞治疗原发性肝癌的研究现状[J].介入放射学杂志,2011,(12):1010.
 AO Jin,ZHANG Yue-wei,XU Ke..Gelatin sponge particle used as an embolic agent in transcatheter arterial chemoembolization treatment for primary hepatocellular carcinoma: its current situation in research[J].journal interventional radiology,2011,(12):1010.
[6]杜丹丹,吕维富. 肝癌射频消融后的影像学评价[J].介入放射学杂志,2012,(01):75.
 DU Dan dan,Lv Wei fu..Imaging evaluation of liver cancer after radiofrequency ablation therapy[J].journal interventional radiology,2012,(12):75.
[7]赵 艳,韩国宏,白 苇,等. 药物缓释微球肝动脉化疗栓塞治疗肝癌研究进展[J].介入放射学杂志,2012,(01):78.
 ZHAO Yan,HAN Guo-hong,BAI Wei,et al.Transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma: its research progress[J].journal interventional radiology,2012,(12):78.
[8]何海涛,刘 圣,刘建秦,等. 肝癌TACE术并发脑碘油栓塞二例并文献复习[J].介入放射学杂志,2012,(08):682.
 HE Hai- tao,LIU sheng,LIU Jian- qing,et al. Cerebral Lipiodol embolism occurred after transcatheter arterial chemoembolization for hepatocellular carcinoma: report of two cases with literature review[J].journal interventional radiology,2012,(12):682.
[9]罗中华,秦 勉,张学昕,等.原发性肝癌合并下腔静脉及右心房癌栓的动脉内化疗栓塞治疗[J].介入放射学杂志,2012,(12):1035.
 LUO Zhong? hua,QIN Mian,ZHANG Xue? xin,et al. Transcatheter arterial chemoembolization for hepatocellular carcinoma complicated by tumor thrombus in inferior vena cava and right atrium[J].journal interventional radiology,2012,(12):1035.
[10]徐 阳,臧 爽,陈路锋,等.Logistic回归及ROC曲线综合评价血生化指标对肝癌TACE术后发热的预测价值 [J].介入放射学杂志,2013,(06):513.
 XU Yang,ZANG Shuang,CHEN Lu? feng,et al. Combination evaluation of plasma biochemical indexes with Logistic regression and ROC analysis in predicting hyperthermia after transcatheter hepatic arterial chemoembolization for liver cancer[J].journal interventional radiology,2013,(12):513.
[11]胡清雯,钱国军.经皮肝穿刺微波治疗肝癌的严重并发症18例分析[J].介入放射学杂志,2014,(01):38.
 HU Qing? wen,QIAN Guo? jun..Severe complications of percutaneous microwave coagulation therapy for hepatic malignancy: an analysis of 18 cases[J].journal interventional radiology,2014,(12):38.

备注/Memo

备注/Memo:
(收稿日期:2016-05-09)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2016-12-15